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Treatment. — No treatment, 12; private doctors, 10; hospitals, 46;
not known, 5.
In many of the cases the treatment was desultory, the child being taken to
the doctor for a "bottle" when it has had a fit. A steady improvement is noted
over previous years. Parents are beginning to understand the necessity for regular
medical care in epilepsy and are less prone to rely on the child "growing out of the
fits at seven or fourteen." No estimate could be formed of the efficacy of the treatment
given, as these cases are ex hypothesi the failures of all methods. All except
two were cases of idiopathic epilepsy.
Conduct.—Fifteen out of seventy-three had reports of serious misconduct,
either temporary or permanent. The records include two attempts to strangle
younger brothers or sisters, persistent pilfering, attacks on adults with knives,
dangerous spitefulness in school. Two factors are clearly at work in producing this
situation. The first is the epileptic process itself, which is of the nature of a cerebral
irritation and is notoriously apt to manifest itself in uncontrolled and impulsive
actions. The mechanism is probably analogous to that which produces somewhat
similar effects in encephalitis lethargica. In several cases in this series the misbehaviour
is definitely associated with fits.
G. P. came up with two reports. The one from a private doctor stated "has
tried to strangle a girl with a noose and threw knives at people." Another from his
teacher was uniformly laudatory—"the loveliest little boy in the school"—"quite
a little gentleman"! G. P. turned out to be a quiet little fellow of eight whose
life had been blameless except for this sudden outburst of violence and malice after
a bad bout of fits.
Another small terror of 6| was described as the "pest of the neighbourhood."
His speciality was pelting the police with over-ripe oranges, pilfered from barrows—
but he had also attempted to shave himself and the baby with his father's (nonsafety)
razor. He, too, was docile and rational except when the fits were on him.
The second factor making strongly for misconduct is lack of reasonable home
discipline, which is very common in epileptic children. The parent is afraid to
correct in any way, and the child learns to exploit its fits to attain its ends.
Where school attendance is contra-indicated, the habits acquired in running
the streets go to complete the deterioration of character. Examples of the grossly
"spoilt" child are commonest among those who refuse colony treatment. Two
children who had been for years out of school were thought at first to be either deaf
or imbecile; it turned out they had simply learned to ignore the sound of the female
voice. Another small boy had established a reign of terror over his family, his
mother admitted he was bribed all day long to placate him. When his long-suffering
father at last attempted to chastise him for ill-treating his sister, he ran to fetch a
policeman, explaining to the astonished officer that he "had fits and must never be
punished." The need of residential school care for such children is overwhelming.
Heredity.—A return of the family incidence of epilepsy would need closer enquiry
than it is possible to give in these cases. It was noted, however, that in the great
majority of cases the history is negative as regards "fits." In only three instances
did the parents admit the occurrence of fits in themselves after reaching adult life,
and in only one case was the condition serious enough to interfere markedly with
the daily work.
The medical work of the special schools for the deaf is under the charge of
Mr. Yearsley, whose report is summarised as follows:—
Examinations at the County Hall.—There has been a great change in the work
during the past year. The sittings have been 47, as against 24 during 1925, while
the number of children examined was 763, as compared with 366 in 1925. The
average number per sitting was 16.2 as against 15.2 in 1925. An analysis of the
results of these examinations shows the change which has occurred in the nature
Mr.
Yearsley's
report on
deaf
children.